Summary
Skills
Accomplishments
Work History
Education
Overview
BusinessAnalyst
MELISSA MORALES

MELISSA MORALES

Rentz,GA

Summary

Dedicated professional with a history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand as well as excellent customer relations aptitude and relationship-building skills.

Skills

  • Industry Product Knowledge
  • Data Integrity
  • Quality Assurance Evaluation
  • Issue and Complaint Resolution
  • Outstanding Interpersonal Skills
  • Customer Retention Strategies
  • Policy and Procedure Adherence
  • Complaint investigation
  • De-escalation techniques
  • Excellent communication

Accomplishments

  • Recognized for outstanding dedication to patient care.
  • Awarded “Highest Ranked” (GEICO) in 2018 & 2019.
  • Compliance Champion 2023 (UHC)



Work History

Service Escalation Account Mgr./Govt. Operations

UnitedHealthcare
07.2022 - Current
  • Built industry knowledge and took initiative to learn additional processes.
  • De-escalated difficult member and provider situations, stayed positive and maintained composure while providing resolution.
  • Engaged clients in health-related activities to enhance overall well-being.
  • Contacted members and providers by phone to ascertain compliance with required and/or recommended actions.
  • Ability to work independently or with others in a fast paced environment by prioritizing task while multi-tasking.
  • Resolved complex customer issues through effective communication and problem-solving techniques.
  • Conducted audits to identify areas for improvement and to ensure compliance standards are met.

Insurance Specialist

AmerisourceBergen
01.2019 - 01.2022
  • Processed eligibility and benefits verification and authorization requests.
  • Researched and resolved routine and complex issues.
  • Resolved discrepancies in insurance benefits by collaborating with carriers.
  • Monitored changes in insurance industry to stay compliant with relevant laws and regulations.

Licensed Insurance Sales Agent

GEICO
01.2015 - 01.2019
  • Recommended type and amount of coverage based on analysis of customers' circumstances using persuasive sales techniques.
  • Upsold additional products and services after identifying customer needs and requirements.
  • Provided comprehensive product knowledge and guidance to help clients on product selection.
  • Obtained underwriting approval by completing application for coverage.

Warrant Clerk

Laurens County Sheriff's Office
01.2012 - 01.2015
  • Processed documents and materials to disseminate information to appropriate parties.
  • Reviewed files, records and other documents to obtain information to respond to requests.
  • Provided quality clerical support through data entry, document management, email correspondence, and overseeing operation of office equipment.
  • Compiled and analyzed data to produce reports.
  • Purchased and maintained office supplies.

Business Office Representative/Insurance Specialist

Fairview Park Hospital
01.2007 - 01.2012
  • Insurance verification for surgical procedures.
  • Calculated patient portion and established payment arrangements.
  • Hospital Banking
  • Maximized cash flow through optimal billing and collection processes.
  • Updated reports, managed accounts, and generated reports for company database.
  • Utilized company's accounting systems to review reports and prepare assessments.

Executive Sales Coach/Customer Support Retention Manager

Get Motivated Business Seminars
01.2005 - 01.2007
  • Successfully piloted and launched Phil Town's Five Step Formula to the Stock Market
  • Leveraged data and analytics to make informed decisions and drive business improvements.
  • Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
  • Developed new strategies for customer retention activities.
  • Planned, created, tested and deployed system life cycle methodology to produce high quality systems to meet and exceed customer expectations.

Certified Medical Assistant

Health Pointe Medical Group
01.2003 - 01.2005
  • Specialized with ADD and ADHD Pediatrics
  • Conducted preliminary patient evaluations measuring weight, temperature and blood pressure.
  • Obtained client medical history, medication information, symptoms, and allergies.
  • Assisted with routine checks and diagnostic testing by collecting and processing specimens.
  • Completed clinical procedures and gathered patient data for interpretation by physician.
  • Enhanced patient outcomes by providing knowledgeable education on procedures, medications, and other physician instructions.

Education

Certified Medical Assistant

Institute of Ultrasound Diagnostics
Tampa, FL

Overview

25
25
years of professional experience

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MELISSA MORALES